King's Trail Cowboy Church

Child's First Name (required)

Child's Last Name (required)

Parent/Guardian's First Name (required)

Parent/Guardian's Last Name (required)

Street Address

Mailing Address (if Diffenert)

Country

City

State

Zip/Postal Code

Cell Phone Number (required)

Home Phone Number (required)

Email (required)

Birth Date yyyy-mm-dd (required)

Allergies (if any)

Any additional information you would like to provide?

Emergency contact 1 Name and phone

Emergency contact 2 Name and phone

Who may pick up your child at the end of each VBS day?

May we have permission to photograph your child?
Yes
No

May we have permission to use your child's photograph for the purpose of promotion?
Yes
No

Does your child attend a childrens group on Sunday? If so, Where?

If your child is visiting our church, who is he/she a guest of?

VBS Registration